Paediatric chest radiographs
Mymoona Alzouebi takes us through chest radiographs—a fundamental part of a child's clinical assessment
Interpretation of the chest x ray is a skill that receives little emphasis in undergraduate training. Although you may have some experience of looking at adult chest x rays, remember that “children are not small adults” and that paediatric chest x rays present in different ways and with different diseases. To add to the confusion, normal anatomy changes during childhood and the most difficult questions to answer are often “is this normal or abnormal?” or “which side is abnormal?” This article aims to help you understand some of the issues involved.
A systematic analysis of the film is the best way to proceed and should include: Patient identificationLung volumes and positioningLungs—too lucent or too opaque?Heart and mediastinumReview areas
Do not forget: Patient's details (ideally name, date of birth, and hospital number)Date of the radiographSide marker (left or right)
With underinflation, the third or fourth anterior ribs crosses the diaphragm. This